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Have Post Orgasmic Illness Syndrome. Suggest the treatment?

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Psychiatrist
Practicing since : 2004
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I want to thank you for your last advice on how to sooth me. You are great for putting in the great effort in helping me with that.

Now, I have an issue that I want to ask you. I strongly believe that I have Post Orgasmic Illness Syndrome (POIS) and I already told my family doctor almost two weeks ago about it and my family doctor told me that sorry he don't specialize in POIS. Before I even know that I have POIS, my family doctor already referred me to total of two urologists, and I saw both of them. The first urologist told me to pray to God and the second urologist tried total of two medicine one at a time each and the second urologist's medicine didn't work. But, both of those urologists at that time didn't know that I have POIS.

I was referred to a third urologist yesterday morning, and I still need to wait for the approval, but I doubt that third urologist will even help although I don't know him. So I cannot be certain, but I think I don't have much luck with that third urologist on my POIS because this is what happened so far.

Do you have any recommendation for supplement(s) that can help me fight my POIS? Please refer, as you probably know of POIS, I have POIS, and I feel very very awful, I need something to treat or cure it.

Note, that me and my psychiatrist already have multiple times all agreed that I DO NOT need any psychiatric medicine for POIS, my psychiatrist said that I should see an internalist for internalist problems, so never mind about psychiatric things for my POIS. My psychiatrist said that I'm very stable on my current medicine, so I don't need to change my current medicine treatment.

I first have the symptoms starting in mid-May to August, 2009 and every year it became worse every year, and just from recently I discovered, which I strongly believe I have Post Orgasmic Illness Syndrom (POIS).

Please refer. Your patience and help is very appreciated.

Note that I'm leaving the country to go to Taiwan next month on November 14, and I will stay there for three months, which I come back on February 12, 2014. So, I have a short time limit while I'm here in the United States to treat my POIS, and I hope I can get something to treat or cure it, so I wouldn't be awful when I'm in Taiwan. Please refer and help.
Posted Thu, 31 Oct 2013 in Mental Health
 
 
Answered by Dr. Ashish Mittal 26 hours later
Brief Answer:
Please provide description of your suffering.

Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     36 year old male
•     Known case of Psychiatric illness from 17 years of age.
•     Currently on Risperidal, multivitamins, Vit D and Coenzyme Q
•     Complaints of: POIS.

I am sad that you have it, as it is a very disturbing condition. Most important thing in POIS treatment is to establish diagnosis. As it one of the very uncommon and treatment resistant condition.

Same time other condition which can increase the symptoms of POIS:
-Guilt of masturbation.
-Stress in life.
-Psychiatric illnesses
-Medicine side effects

It will be better if you can write about your suffering in your own words so that I can recommend some investigations or treatment. Also provide name of your psychiatric condition. I hope your psychiatrist aware about use of chinese herb use, if not then make him/her aware regarding this.

In my opinion, as many of the symptoms in POIS are psychological, so psychiatrists are in better position to understand it rather than Urologist.

Although your psychiatrist had denied psychological origin of symptoms, but I think you should seek in person second opinion from different psychiatrist, as you are taking opinion from different urologist.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,
Above answer was peer-reviewed by
 
Follow-up: Have Post Orgasmic Illness Syndrome. Suggest the treatment? 3 hours later
1.) My symptom first began and started in Mid-May to August, 2009 when after my mother stopped her Hepatitis B medication for one month during March to April, 2009 because her insurance got discontinued. But, my mother did told me that she did took her Hepatitis B medication back after one month. My mother did took her Hepatitis B medication back after she stopped it for one month.

What happened was after the situation that I described above on my mother stopped her Hepatitis B medication for one month, but she did took it back after she stopped it for one month, then apprx. one and a half months later in Mid-May, 2009, that time in the night, I masturbated in that night, and after I masturbated, that same night, I think I caught either a flu or a fever in that same night. Because at that time my mother was already out of town for three months period, so that night after as I mentioned that I masturbated and caught a flu or a fever in that same night, because I wasn't doing good financially at that time, so I cheated on my diet and I didn't eat good in that same night, and I didn't eat good for a few days after that night too. I kept drinking milk and I didn't eat good on that night after I masturbated and caught a flu or a fever on that night and I didn't eat good after that night for a few days too.

Then, since after that night and after a few days after that night, then starting in Mid-May to August, 2009, my symptom began. My symptom began starting in Mid-May to August, 2009, which my symptom is that starting in August, 2009, after I masturbate, I would have a very bad "infectious feeling" in my body from the stomach area up to the chest area and also up to the head too, and while I have that "infectious feeling", I would sleep for more than 12 to 13 hours.

This symptom got worse and increased every year. In 2010, after I masturbate, then I would have again, that "infectious feeling" in the body and while have that "infectious feeling", I would sleep for more than 15 to 16 hours while have that "infectious feeling". Then, in 2011, it increases again, in 2011, after I masturbate, I would again, have that "infectious feeling" and while I have that feeling, I would sleep for more than 22 to 24 hours. In 2012, after I masturbate, I would have that "infectious feeling" and I would sleep for more than 30 to 35 hours! There's one time this year in 2013 that after I masturbate, I would have that "infectious feeling" and while have that feeling, I slept for more than 45 hours.

(Note that I want to let you know that although I slept for that long, but during sleep, I ALWAYS and ALWAYS managed to forced myself to get up and take my medication on time and eat. So, although I slept for that long, but I always managed to forced myself to get up and take my medication on time and eat. I ALWAYS got up and I always take my medication on time and I never have once missed a single dose of my medication, I always take my medication on time although I sleep that long. After I always managed to got up and take my medication always on time and also after I ate, then I went back and fall right back to bed and sleep.)

I want to let you know that when this symptom began in Mid-May to August, 2009, then I didn't go see my family doctor to treat this symptom right away and I think that is why this symptom got worse in the first place. I waited one year after this symptom first began in August, 2009, which I started to go see my family doctor regarding this symptom in March to April 2010.

When I first started to see my family doctor regarding this symptom in March to April, 2010, the family doctor did the health check, CBC test as well, and did also Hepatitis A, B, and C test. Then, my family doctor told me that my health check shows normal, my CBC is normal too, and he said that I do not have Hepatitis A, B, nor C.

In the past for apprx five years, starting from my 1st opinion family doctor to my 2nd opinion family doctor to my current 3rd opinion family doctor, they all did a bunch of health check blood test, and Hepatitis A, B, and C tests as well, and CBC, and there's also ultrasound did twice too in last year and this year. And the doctors all tell me that my health test shows that I'm very healthy. I'm diagnosed with fatty liver one year ago, but my fatty liver disappeared five months ago. My recent blood tests shows that my Vitamin D is very low, and I already had finished three months ago of the four weeks of Vit D 1.25 mg (50,000 units) of medication for to be taken once per week for total of four weeks. I finished that four weeks of Vit D 1.25 mg three months ago. Then, my current 3rd opinion family doctor just prescribed to me three days ago another new dosage of the same Vit D 1.25 mg (50,000 units) medicine, but this time this Vit D 1.25 mg medicine is for to be taken twice a week for total of two months for now instead of the previously once a week. I will be starting to take this current Vit D 1.25 mg medicine starting tomorrow on Monday for twice a week (instead of the previously once a week.).

P.S. Note that since this symptom, which I described above, had started in August, 2009, then ever since after this symptom began in August, 2009, then I learned a lesson, and therefore starting in 2010 to 2011, I began and started to watch out on my diet and I always make sure myself to eat good.

So, ever since this symptom which I described above that began in August,
2009, then starting in 2010 and 2011, I had always been very careful and
I had always been made sure that I definitely eat good and I made sure
that I eat good consistently starting in 2010 to 2011 until now, which I am
still eating very good right now still.

So, the above is the cause and effect of how my symptom began, and my tests, which my tests shows that I'm pretty normal.


2.)Regarding the psychiatrist knowing that I use the herbs for mental illness:

I want to let you know that OF COURSE my psychiatrist is actually very aware that I'm taking Chinese herb medicine for my mental illness. In fact, I started to take the Chinese herb medicine for my mental illness starting in 2009 to until 2011, and then stopped taking it, and then I started to take another new Chinese herb medicine for my mental illness again in 2013 until now that I'm still taking it, and these Chinese herb medicine all comes from that same herbalist person. My psychiatrist was with me and he had seen me once per month for every single month while I'm taking the herb medicine for mental illness. My psychiatrist had seen me improved extraordinary while I was taking the herb medicine for mental illness in 2009 until 2011 and I started taking the herb again this year in 2013 until now I'm still taking it.

My psychiatrist is very aware that I improved extraordinary while I'm taking the herb medicine for mental illness. He actually told me this year that "your Chinese medicine definitely works!".

3.) Regarding seeing a psychiatrist for POIS:

My psychiatrist told me this year that I'm doing very stable with my current Risperdal medicine. My psychiatrist told me that I do not need to change my current medicine treatment.

I do not need to change my current medicine treatment and that is the bottom line. I'm O.K. right now with what I'm taking, and that is the bottom line.

My psychiatrist have agreed that my problem is an internalist problem, and he agreed and I believe an internalist can solve my POIS.

I want to let you know that I did see my psychiatrist this week and I did told him for the first time ever that I have POIS. Then, my psychiatrist's told me that his suggestion is "ABS", which he said "ABS" means he want me to stop masturbate.

This is not the first time that my psychiatrist told me to stop masturbate. When I had my symptom which I described in #1 above, my psychiatrist have suggested many times that he want me to stop masturbate. My psychiatrist told me that the best thing to do is to stop masturbate, that is his suggestion.


Also 3b) Also, let's stop talking regarding and let's forget about using psychiatric things to help me stop masturbate. I'm very certain that I'm not the kind of person that need any psychiatric things to stop masturbate and I am very certain on that. Let's forget about using psychiatric things to help me stop masturbate.

I had already took Prozac before for two weeks and that medicine made my body had many bad effects including making too my heart beat very very fast PLUS that medicine don't work for me. I stopped it after two weeks already.

Again, I'm very certain that I'm not this kind of person that need psychiatric medicine to help me stop masturbate, so that is the bottom line, so let's forget about using psychiatric medicine to help me stop masturbate because psychiatric medicine wouldn't work for me anyway on that, and I'm not the suitable person to be used for psychiatric medicine to stop masturbate.

My psychiatrist already told me that I'm doing very stable on my current Risperdal medicine and he said that there's no need to change my current medicine treatment. So, therefore let's forget about the subject of using the psychiatric medicine to help me stop masturbate because I do not need that. That is the bottom line.

4.) I explained my situation above, so can you refer to me supplement and/or treatment to cure my POIS?

Note that I'm leaving the country to Taiwan next month on November 14 and I'm coming back on February 12, 2014, so I'm out of time, and I have only a short time to treat my POIS before I go to Taiwan.

As you would already know, having POIS is feeling very awful. So, please refer supplements and/or treatment for my POIS, so that since right now I have a short time here, so then while I'm in Taiwan, I wouldn't be awful.

Thank you for your patience in reading this message and your help is very much appreciated.

Please refer, please help.
 
 
Answered by Dr. Ashish Mittal 20 hours later
Brief Answer:
Escitalopram can be helpful.

Detailed Answer:
Hello again,
Thanks for follow up.

From the further information and normal lab results, it is clear that your problem is difficult and can not managed by XXXXXXX medicine physician/Urologist. It is chronic problem and may take time to improve, so you need to keep patience.

It is nice to see that, you have already get investigated your case in best manner. Few researcher has proposed that POIS is caused due to neurochemical imbalance in brain. Few patient got relief with selective serotonin reuptake inhibitors (SSRI). These medicine also decreases desire to masturbate. Your psychiatrist already had tried Prozac which is a SSRI. It take 1-2 months for medicine to show effect, but you stopped medicine due to side effects which is common at initiation of treatment, but many side effects subside after 2-3 weeks.

As Prozac is not suitable for you, then in my opinion you should try another SSRI like Escitalopram under your psychiatrist supervision. To prevent side effects start with lowest dose 5mg then increase dose gradually.

I hope it will work in your case and will reduce your suffering.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Regards
Dr Ashish Mittal, MD
Above answer was peer-reviewed by
 
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